War-torn Liberia already had too many orphans. Then came Ebola.

Esther Tokpah, an 11-year-old orphan, cries as Jerry Brown, a doctor, tries to console her before she is released from an Ebola treatment center in September in Monrovia, Liberia. Both of Esther’s parents died from Ebola. (Michel du Cille/The Washington Post )

MONROVIA, Liberia — Berlinda Clark arrived by ambulance at Redemption Hospital, a hellish holding center for the sick and the dead. Also in the back of the vehicle was the corpse of her mother, who died before the child’s eyes on the trip over.

As luck would have it, Katie Meyler was outside Redemption that September day as well. Meyler, a New Jersey native who runs a nonprofit group in the slums here, brought the 4-year-old girl to live in the clean, newly renovated guest house her organization owns — a reversal of fortune akin to hitting the lottery in a place where the Ebola virus is out of control.

But then Meyler plucked another child, Miatta Urey, from a nearby home full of people who were sick with the Ebola infection and brought her to the guest house as well. Miatta soon began showing symptoms of infection and became seriously ill, posing yet another threat of exposure to Berlinda.

Meyler’s actions may have been imprudent, but they also demonstrate how few choices are available to those trying to care for the children of the Ebola epidemic.

In a country still recovering from 14 years of civil war, Ebola is posing a new threat to children, with challenges never seen here before. Some children have been forced to leave homes where relatives are infected, cleaving families into the sick and the well. Others face stigma if parents or siblings contract the disease, or they are shunned if they get it themselves and are fortunate enough to survive. And Liberia has a new wave of orphans, like the one caused by the war.

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As Ebola continues to spread, Liberia and other countries struggle to care for the children orphaned by the deadly virus.

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As Ebola continues to spread, Liberia and other countries struggle to care for the children orphaned by the deadly virus.

Sept. 21, 2014Berlinda Clark, 4, plays while her caregiver Bendu Fayiah speaks to visitors in Monrovia, Liberia. Berlinda’s mother died on the way to the hospital two weeks ago. Berlinda is being cared for by an organization called More than Me. Michel du Cille/The Washington Post

The Liberian government and Western aid agencies are scrambling to respond with makeshift arrangements as they try to track down relatives who might take in the abandoned children. But, UNICEF said, “many [children] are being rejected by their surviving relatives for fear of infection.”

“This is all uncharted territory for us,” said Sarah Crowe, a spokeswoman for UNICEF. “We’ve never done anything like this. “

UNICEF announced last week that 3,700 children in the three nations hardest hit by Ebola — Liberia, Guinea and Sierra Leone — had lost one or both parents. Among the ways the organization responded is by housing 13 children in the Hawa Massaquoi center, a former orphanage dating from the civil war of 1989-2003, until parents or relatives could be found.

Some children understand that they have lost one or both parents. Others cling to hope that a mother or father will emerge from an Ebola treatment center and take them home.

“My mother got sick,” one boy there said. “My grandfather died. And then my father said my mother should not come close to him because she could give him the virus. And then the ambulance came and took her to the hospital, and after a few days, we heard she had died in the hospital.”

Meyler said when she saw Berlinda’s circumstances, she made a snap decision to take her in, rather than leave her to the nightmarish conditions inside Redemption Hospital. On a recent day, at the guest house of Meyler’s aid group, More Than Me, Berlinda puttered around the freshly painted rooms, poking into this and that, much as any 4-year-old would. She believes her mother died because she went out in the rain. Her caretaker, Bendu Fayiah, a 22-year-old woman whom the girl soon began calling “Mother,” said the child tells her, “Mama, don’t go to the water. Don’t go into the rain.’ ”

Berlinda’s father is unable to care for her. With schools here closed in an attempt to slow transmission of the virus, More Than Me was paying Fayiah, one of the teachers in the small school it runs, to live in the guest house with the child. Unsure whether Berlinda was infected with Ebola, Fayiah at first wore some protective clothing and surgical gloves. But after her own mother told her she would pray for the child’s health, Fayiah abandoned them, increasing the risk to herself if the child was infectious.

More than a dozen drugs are being studied for treating Ebola and other filoviruses.

“I felt it was the calling of God to take care of this child,” she said.

The risks, though, soon became evident. Berlinda vomited twice last Thursday, Meyler later said in an e-mail. Vomiting can be a sign of Ebola infection, but it is also a symptom of other diseases common to West Africa, such as malaria.

Berlinda tested negative for the Ebola virus and is now in the care of a volunteer family, Meyler said in a subsequent e-mail.Miatta, however, is seriously ill from Ebola infection. Meyler is working with the Liberian government to reconfigure the guest house to temporarily accommodate as many as 40 displaced children.

‘This is the only way forward’

The region’s children have seen this before. The fate of war orphans in Liberia and Sierra Leone offers a bleak glimpse into what the future holds for those left without families by Ebola.

In the wake of Liberia’s civil war, orphanages were suspected of participating in child trafficking. The “chronic deplorable conditions” in Liberian orphanages were deemed a “cause for major concern” in a 2007 report from the United Nations mission in Liberia. Children were often undernourished, slept on floors and had no access to toilets. In one orphanage, a locked room with no mattresses was reserved for children who wet the bed, the report said.

Both Sierra Leone and Liberia suspended international adoption in 2009, citing concerns about illegal activity. In Liberia, the move came after reports of irregularities in the way unlicensed agencies brought children to the United States for adoption.

Aid workers say informal caretaking arrangements are developing on their own in some places. They include efforts by survivors of Ebola, who carry antibodies to the virus, to care for children who may have been infected. Such children must be quarantined and monitored for 21 days.

Save the Children, a well-established aid group, is trying to match survivors with childrenwho need them. And UNICEF plans to train Ebola survivors to help care for kids during the 21-day waiting period.

“How can you care for children without holding them and loving them and nurturing them?” Crowe said. “This is about innovative solutions. This the only way forward.”

Some traditional methods of helping children cope with trauma are impossible in a time of Ebola. Save the Children has, in other places, organized soccer games for youngsters affected by natural disasters or war.

Such gatherings “can’t happen because of the infection control that has to happen,” said Seema Manohar, one of the group’s representatives in Monrovia.

There have been small victories as the virus spreads through Liberia. Social workers located the parents of a young girl staying at the Hawa Massaquoi Center, who was originally thought to be an orphan. When she began showing symptoms of Ebola, she was taken to a treatment center and appears to be recovering.

Another young girl, Esther Tokpah, lost both parents but survived the disease herself at ELWA 2, a treatment center run by Liberian doctor Jerry Brown. As 14 other survivors prayed and sang at a ceremony celebrating their release in late September, Esther, 11, wept bitterly, tears pouring down her face as a heavy rain clattered on the corrugated metal roof of a shelter above the group’s head.

Meyler, who was there to deliver a load of vitamins, took Esther to live at the guest house, and the girl later moved toa government-run home for orphans.

“She colors, she danced today and yesterday,” Meyler said in an e-mail last week. “She’s becoming more alive.”

Sullivan reported from Washington.

Lenny Bernstein covers health and medicine. He started as an editor on The Washington Post’s National desk in 2000 and has worked in Metro and Sports.